Accelerated Motion Physiotherapy

Low back pain and SOCIAL DETERMINANTS of health: a systematic review and narrative synthesis How do the broad range of SDH and chronic LBP relate? What are the associations between the SDH and CLBP-related disability, work absenteeism, and opioid prescription?... n = 41 studies, 2.1 million subjects The SDH define the conditions in which people are born, grow, live, work, and age, and the inequities in power, money, and resources that are responsible for disparities in health outcomes. Addressing the SDH requires upstream approaches involving policy level influence over the distribution of wealth, power, and opportunities-an approach commonly described as one that considers the causes of the causes of poor health outcomes. https://pubmed.ncbi.nlm.nih.gov/32910100/

Nutritional intervention in chronic pain: an innovative way of targeting central nervous system sensitization? https://www.tandfonline.com//10.1080/14728222.2020.1784142 Nutritional neurobiology and central nervous system sensitisation: missing link in a comprehensive treatment for chronic pain?... https://bjanaesthesia.org/ar/S0007-0912(19)30579-3/fulltext

Does hip or knee joint replacement decrease chances to complete an ultra-trail race? Study in participants at the Ultra-Trail du Mont Blanc Race Parameters = 171 kilometres (106 mi) and total elevation gain of 10,040 metres (32,940 ft).... The race was finished by 3 of the 6 runners with a total hip arthroplasty (THA), all of the 8 runners with a hip resurfacing arthroplasty (HRA) and 3 of the 4 runners with a total knee arthroplasty (TKA). Conclusion : Running ultra-trail is possible after a hip or knee joint replacement. All of the 8 runners with HRA finished the race. We may remain cautious about the long-term survival of prostheses. https://pubmed.ncbi.nlm.nih.gov/33191172/

Back to basics: 10 facts every person should know about back pain https://bjsm.bmj.com/content/54/12/698

Are any treatment modalities for FROZEN shoulder associated with BETTER outcomes than other treatments? It appears that the use of an IA CORTICOSTEROID for patients with frozen shoulder of duration less than 1 year is associated with GREATER benefits compared with all other interventions, and its benefits may last as long as 6 months. A home exercise program with simple ROM exercises and stretches administered with or without IA corticosteroid appeared to be associat...ed with SHORT-TERM pain benefits. IA corticosteroid is associated with BETTER short-term outcomes than other treatments, with possible benefits extending in the mid-term; therefore, we recommend its early use with an accompanying home exercise program. This can be supplemented with physiotherapy to further increase the chances of resolution of symptoms by 6 months. https://jamanetwork.com//10.10/jamanetworkopen.2020.29581 Physiotherapy = mobilizations, application of ice and heat, diathermy, electrotherapy modalities

This one is hot off the press! Besides using a very interesting study design in network meta-analysis (NMA), this article reviewed and analyzed the available exercise literature to try and answer the question: Which exercise types are best for treating chronic non-specific neck pain?"... Comparative effectiveness of physical exercise interventions for chronic non-specific neck pain: a systematic review with network meta-analysis of 40 randomised controlled trials (Zoete et al., 2020, BJSM): https://bjsm.bmj.com///11/02/bjsports-2020-102664.abstract

Manual Therapy

Emotional First Aide The Role of Exercise in Management of Mental Health Disorders: An Integrative Review Conclusions:... Aerobic and resistance exercise training hold promise in the treatment and management of mental health conditions, particularly depression and anxiety. Emerging evidence suggests that changes in underlying neuroplasticity may be an important individual difference explaining heterogeneous treatment benefits. Underlying individual differences in neuroplasticity, either at baseline or in intervention-related changes, likely have significant implications for individuals developing and sustaining behavioral self-regulatory skills essential for mental health. These factors likely work in synergy, creating a virtuous cycle to predict long-term effects of exercise on mental health. https://www.annualreviews.org//1/annurev-med-060619-022943

A Contemporary Approach to Patellofemoral Pain in Runners https://meridian.allenpress.com//A-Contemporary-Approach-t

Back pain in the workplace. What you lift or how you lift matters far less than whether you lift or when Likewise, rather than pursuing the "right way to lift," the more reasonable and humane quest might be for workplaces that are comfortable when we are well and accommodating when we are ill. - Hadler 1997... https://pubmed.ncbi.nlm.nih.gov/9152441/

Barriers and facilitators to patient uptake and utilisation of DIGITAL interventions for the self-management of low back pain: a systematic review of qualitative studies Engagement and learning is likely facilitated or not facilitated with the following: Helpful ... content easily understandable providing regular updates and prompts ability to interact with other users information easily accessible and structured tailoring experience particularly valued. Unhelpful large volumes of information and lack of time lack of support or encouragement from HCPs patient preferences for treatment at times missing or conflicting information content that was not tailored to the individual lack of feedback or evaluation. https://bmjopen.bmj.com/content/10/12/e038800

Do ‘sliders’ slide and ‘tensioners’ tension? Yep Neurodyanmic exercises are purported improve nerve mobility relative to their surrounding structure and induce intraneural pressure changes that may desensitize the peripheral nerve.... If symptoms are moderate to highly irritable, it has been suggested these exercises could trigger ectopic discharges within the nerve (Dilley 2005) and exacerbate symptoms. Thus, irritability may be one factor in deciding whether to start with ‘sliders’ or ‘tensioners’. The current study demonstrated: 1Sliders do not increase nerve strain, tensioners do. 2Sliders provide greater nerve excursion versus tensioners. 3 Tensioners > Sliders may have benefits for nerve hydration and intraneural pressure from a ‘pumping action’ or ‘milking effect’. More interesting thoughts in the study : Cadavers : https://www.ncbi.nlm.nih.gov/m/pubmed/17398140/ In-vivo : https://pubmed.ncbi.nlm.nih.gov/19252262/

Effectiveness of a Group-Based Progressive Strength Training in Primary Care to Improve the Recurrence of Low Back Pain Exacerbations and Function: A Randomised Trial The intervention group showed a recurrence rate of 8.3%, while the control group had a recurrence rate of 33.3% and a shorter time until the first recurrent episode. https://pubmed.ncbi.nlm.nih.gov/33187076/

Patient expectation of physical therapy and Neck pain. The big picture concept here is that it pays to fully understand your patients expectations for treatment and incorporate them into a good evidence based plan of care. Not only does this help to provide patient centred care, but it helps to prognosticate and improve outcomes for treatment satisfaction in the short-term and decrease disability in the long-term.... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5175452/ Take-ways : 1 In general patients seeking out physiotherapy for neck pain had high expectations that treatment would help. 2 Patients expected manual therapy and exercise would be the most helpful interventions, which is inline with clinical practice guidelines. 3 General expectations of pain relief had an important influence on treatment outcomes. 4 "Matching the patient's belief that manipulation would help with receiving manipulation might have added the short-term benefit of perceived success, but this benefit was lost by 6 months."

Effectiveness of progressive tendon-loading exercise therapy in patients with patellar tendinopathy: a randomised clinical trial https://bjsm.bmj.com//early/2020/11/19/bjsports-2020-103403

Story time ... About 3-weeks ago I had an assessment with a 75 year-old woman who was reporting a 4-year history of lower back pain. She had received an MRI, chiropractic, physical therapy, and acupuncture to date. She was worried about ‘using’ her back in day to day activities and was told lumbar extension in swimming and yoga may not be safe. She had been doing both these activities for over 25 years and something she really enjoyed. ... After our assessment, I spoke to the MRI (I.e wrinkles on the inside) and advised that her back and hip movement looked good. I asked if she would be willing to start some swimming and or yoga again and if she thought this could be helpful; she said yes to both. I asked when she would like to follow up; she said in 3-weeks. I gave her two exercises and we agreed she should start swimming and yoga again. We followed up and she reported feeling 80% better. I asked what she thought was helpful and mentioned 3 things: 1 She was relieved that the MRI looked normal and thankful for the explanation. 2 She was just waiting for someone to give her permission to move which she deeply thought was the solution. 3 She appreciated someone really listening. I always enjoy asking what people thought made the change for them. Anecdotally, often people say it is advice and the listening as being most helpful, but do enjoy some simple exercises that challenge the symptomatic area.